Group Versus Individual PCIT for Preschoolers with ADHD

针对患有 ADHD 的学龄前儿童的团体与个人 PCIT

• 批准号: 7669163
• 负责人: SHEILA M EYBERG
• 金额: $ 52.18万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7669163
• 关键词: Aftercare; Attention deficit hyperactivity disorder; Behavior; Characteristics; Child; Child Behavior; Conduct Disorder; Cost Effectiveness Analysis; Cost-Benefit Analysis; Data; Diagnosis; Diagnostic; Disease; Disruptive Behavior Disorder; Dropout; Economics; Failure; Family; Goals; Home environment; Hyperactive behavior; Impulsive Behavior; Individual; Intervention; Measurement; Measures; Mediator of activation protein; Methods; Modality; Modeling; Nursery Schools; Oppositional Defiant Disorder; Outcome; Outcome Measure; Outcome Study; Parent-Child Relations; Parenting behavior; Parents; Participant; Patients; Pilot Projects; Psychopathology; Randomized; Reporting; Research Personnel; Sampling; School-Age Population; Schools; Seminal; Services; Severities; Societies; Stress; Structure; Symptoms; Testing; Time; Treatment outcome; age group; base; clinically significant; cost; economic evaluation; externalizing behavior; follow up assessment; follow-up; improved; indexing; informant; interest; meetings; non-compliance; premature; prevent; primary outcome; programs; psychosocial; response; satisfaction; skills; social skills; success; teacher; therapy outcome; treatment response

DESCRIPTION (provided by applicant): Parent-Child Interaction Therapy (PCIT) is an empirically supported treatment for disruptive behavior disorders (DBD) in young children. Approximately 70% of children with a DBD in PCIT studies have a comorbid diagnosis of ADHD. Yet PCIT has not been examined as a treatment for ADHD-related behaviors per se. The objective of this project is to examine a prescriptive model of psychosocial treatment for ADHD in preschoolers. The characteristic of prescriptive interest is the presence or absence of comorbid DBD [Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD)]. The treatments to be compared are Individual PCIT and Group PCIT. A prescriptive model of treatment is proposed to test the hypothesis that families of young children with ADHD who have comorbid ODD or CD will require the more intensive, individualized treatment format (namely, Individual PCIT) to change child behavior, whereas children with ADHD-only will benefit equally from either treatment format. This project has three specific aims: (a) To determine whether children with ADHD-only will differ from children with ADHD + ODD/CD on treatment outcome measures at post-treatment and follow-up; (b) To conduct an economic evaluation of Group PCIT and Individual PCIT for treating ADHD-related behaviors; and (c) To identify determinants of immediate and longer-term treatment response to Individual and Group PCIT formats. Multiple informants and methods of measurement will be used to assess parenting skills, parent psychopathology, and child ADHD-related behaviors at home and school. Participants will be 128 families with a young child (4 to 6 years) with ADHD. Families will be randomly assigned to one of two groups: (a) Individual PCIT, or (b) Group PCIT, stratified by comorbid diagnostic status. Half (64) the children (32 with ADHD-only; 32 with ADHD + ODD/CD) will receive Individual PCIT. The other 64 children (32 with ADHD only; 32 with ADHD + ODD/CD) will receive Group PCIT. Assessments will be conducted at pre- and post-treatment and at 1- and 2-year follow-up points. We expect significant improvement for all children on outcome measures at post-treatment and follow-up assessments. We expect children with ADHD + ODD/CD to show better outcomes after Individual PCIT than Group PCIT on all measures at post-treatment and follow-up. We expect equivalence in primary outcome measures between Individual PCIT and Group PCIT for children with ADHD-only, but we expect the costs of Group PCIT to be substantially lower, providing additional evidence of the utility of prescriptive treatments. We will explore additional moderators of outcome and test models of mechanisms for change by examining intervention- targeted mediators, including parenting skills and parent psychopathology.

描述（由申请人提供）：亲子互动疗法（PCIT）是一种经验支持的幼儿中破坏性行为障碍（DBD）的治疗方法。在PCIT研究中，大约70％的患有DBD的儿童的ADHD合并诊断。然而，尚未将PCIT作为治疗ADHD相关行为的治疗方法。该项目的目的是检查学龄前儿童的ADHD的社会心理治疗的规范模型。规定性兴趣的特征是合并症DBD的存在或不存在。要比较的治疗方法是单个PCIT和组PCIT。提出了一种规定的治疗模型，以检验以下假设：患有合并症或CD的ADHD的幼儿家庭将需要更密集，个性化的治疗格式（即单个PCIT）改变儿童行为，而只有ADHD的儿童只能从任何一种治疗格式中受益。该项目具有三个特定的目标：（a）确定仅在治疗后和随访时对患有ADHD + ODD/CD儿童的儿童与ADHD + ODD/CD的儿童有所不同； （b）对PCIT和个人PCIT进行经济评估，以治疗与ADHD相关的行为； （c）确定对个人和组PCIT格式的直接和长期治疗反应的决定因素。多个线人和测量方法将用于评估家庭和学校的父母精神病理学和与儿童ADHD相关的行为。参与者将是128个带有ADHD的孩子（4至6岁）的家庭。家庭将被随机分配给两个组之一：（a）单个PCIT或（b）组PCIT，通过合并症诊断状态进行分层。一半（64）儿童（32岁，只有ADHD; 32，带有ADHD + ODD/CD）将获得单独的PCIT。其他64名儿童（仅为ADHD的32名儿童； 32个带有ADHD + ODD/CD的儿童）将接收PCIT组。评估将在治疗前和后期进行，并在1年和2年的随访点进行。我们预计，在治疗后和随访评估时，所有儿童都对所有儿童进行了重大改善。我们希望患有多动症 +奇数/CD的儿童在治疗后和随访时的所有措施中，单个PCIT后的结果都比组PCIT表现更好。我们预计，单个PCIT和PCIT的主要结果指标对只有ADHD的儿童进行等效，但我们希望组PCIT的成本大大降低，提供了有关规定治疗效用的其他证据。我们将通过检查针对干预的针对性调解人（包括育儿技能和父母心理病理学），探索结果和测试模型的其他主持人。